BSc Professional Health Studies: Supporting Loss by Suicide Report

This report, prepared for a BSc in Professional Health Studies, analyzes the complex issue of loss by suicide. It begins by identifying the specific loss, providing a rationale for its selection, and using the example of Robin Williams to illustrate the impact of suicide. The report then delves into the analysis and evaluation of normal and complicated grief reactions, differentiating between the five stages of normal grief (denial, anger, bargaining, depression, and acceptance) and various forms of complicated grief (absent, delayed, inhibited, conflicted, chronic, unanticipated, abbreviated, and distorted). Furthermore, the report analyzes and evaluates the role of helpers, including government agencies, specialists, and local services, in supporting individuals facing loss by suicide. It highlights the importance of providing counseling, emotional support, and practical assistance to those affected by this profound form of loss.

HEALTH, NURSING & MIDWIFERY
BSc. (hons) PROFESSIONAL HEALTH STUDIES
Supporting People Facing Loss
NURS09179

Section 1
Identification of loss to be discussed and rationale for choosing
The specific loss which is discussed in Loss by Suicide because it is an act which is
intentionally caused one's own death and there re so many reasons for causing suicide such as
Mental disorder, depression, anxiety disorder etc. For example, Robin Williamson who is the top
actor and comedian addicted to cocaine which led to Robin Williams to major depression and
this is the leading cause of his depression (Robin William's suicide, 2018). Even during his
interview, he continuously mentions his depression. Moreover, in UK, as per the Suicide
Statistics Report there were 6213 suicides in 2017 in which 5821 are registered in UK and 392 in
Republic of Ireland (Suicide Statistics and trends for UK and Republic of Ireland). Such that the
ratio of man is more than woman and the highest suicide rate was for men whose age is in
between 45 and 59 (Suicide Statistics and trends for UK and Republic of Ireland). Therefore, the
report also state that the suicide is mainly caused due to mental disorder or depression and that is
why, the top actor and comedian also suicide because of depression.
As a health Professional, I realize that the specific problem related to loss of Suicide is
such that people may be mentally ill or cause depression and due to frustration, an individual
takes such a wired decision and come to end their lives. Therefore, as a healthcare practitioner, I
evaluated that it is quite necessary to know more about the loss of suicide because it will help to
identify the solutions which need to be addressed so that it will minimize the percentage of
suicide in the country (Cosh and et.al., 2019). Being a healthcare practitioner, I analyse that it is
essential to be aware of general health loss so that it will be easy to make people aware and
provide solutions as well.
Section 2
Analysis and evaluation of normal and complicated grief reaction related to loss identified
Normal Grief is the normal way in which the people respond to the personally painful
and unhealthiness event (Arizmendi and O’Connor, 2015). Such that it is the natural response to
losing someone who is more important and generally people at that time react through different
emotions like sadness and loneliness. As in the case of loss of suicide, the members of Robin
Williamson reacted by crying, tears and sobbing (Robin William's suicide, 2018). Therefore, in
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order to display the grief, Elisabeth Kubler Ross identified the model of five linear stage of
grief which is as mention below:
Denial: It is the earliest stage of Grief which involves the feeling that this is not possible
that it is happening to me. Moreover, the person also think that life makes no sense and they are
in the stage of shock because of sudden change in the life due to losing their beloved (Five stage
model of normal grief, 2018). Therefore, in this stage, the person is not live in reality stage and
denial also assist the person in pacing the feelings of grief.
Anger: In this stage, the person ask why this happen to me only? Or the person also look
for the source of blame and also become angry to the world and start thinking after losing the
beloved ones that no one is there and you are alone in this world. Therefore, when the person is
suffering in this stage, they feel that they are disconnected from the reality and feel inaccessible
and unconstrained.
Bargaining: The stage of grief is used when something bad is happened and people start
dealing with God and start bargaining. But this stage is false hope and generally it is believed
that it is used to avoid the grief through the type of negotiation (Mayton and Wester, 2019).
Depression: It is the commonly accepted form of grief and depression is the present
emotion. Therefore, in this stage, the person did not want to be around others and did not like to
talking with others, and they feel like a hopelessness. However, these type of people even
experience suicidal thoughts and also keep thinking about negative thoughts.
Acceptance: It is the last stage of Elisabeth Kubler Ross in which the emotions are begin
to stabilize and a person start settled down to re-enter reality. Even the person also start
accepting the reality that there are good days and some bad days and then again there are good
days come. Person in this stage start living their life happily and start to engage with friends and
family.
Complicated grief is difficult by adjustment disorders such as depressed and anxious
mood and it is identified by the extended length of time. It Is analysed that It also vary from
person to person, though both normal and complicated grief are not same but if the person is not
able to move on from the five stages of normal grief then it they are lives in complicated grief.
Therefore, In this type of grief, people generally reacted through anger, irritation, an inability to
focus on anything, some intense feeling such as sadness, pain and detachment, sorrow and
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hopelessness, lastly they are not accepting the reality. Therefore, there are different types of
complicated grief such as:
Absent grief: In this type of grief, person acted that nothing is happen and the bereaved
display no feeling of grief and also become detached from the reality. Therefore, in this,
Maladaptive behaviour and emotional numbness Is quite common in absent grief.
Delayed grief: It is generally occurred when bereaved have some responsibilities such
that funeral arrangement and this result in postponed grief (Maccallum and Bonanno, 2016.).
Such that when Robin Williamson died due to depression, his wife and children was devastated
at the loss and then the family members felt it was their duty to take care, and they have to be so
strong and this push away from their own grief and covered it up with endless responsibilities
(Feigelman and et.al., 2019).
Inhibited Grief: It shows when the person changes his behaviour such that they do not
allow themselves to experience the pain directly and it may develop some bodily complaints or
illness. In this, normal expression of grief is suppressed.
Conflicted grief: It also involves the image of one or more behaviours which directly
display normal grief and on the other side, the other aspects is quelled. Therefore, this type of
grief is shows through anger and guilt. Basically, people are confused that they may happy or sad
and this complicated grief arises after the loss of highly troubled and ambiguous relationship.
Chronic Grief: It involves the griever who give reaction which are common in early
stage but this is continued long after the loss has occurred (Stewart and et.al., 2019). Therefore,
the bereaved also seems to keep the dead alive with their grief and thus, this type of grief Is
maintained by the feeling of insecurity and some insecure attachment with the deceased.
Unanticipated grief: This Is occurs when the person suffer from any unexpected or
sudden death and this type of death also involves complicated recovery. Therefore, due to sudden
death, the adaptive capabilities of bereaved may be seriously damaged and as a result, they are
not active in the particular functions, and they are not even accepting the reality and this may
involves the complicated recovery.
Abbreviated Grief: Though it is a normal form of grief and basically the grief process is
a shortened because of the attachment and lost person in immediately replaced. Therefore, this
may also result in shorter grief even after the actual death. Thus, mainly the problem with this
type of grief is like bereaved may show very little sense of condition and even the negative
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feelings also may be blocked way by denying themselves to feel comfortable in this situation
even.
Distorted grief: If the person is suffer from this type of grief then they show extreme
anger and guilt. Such that the person may also often at the risk for the depression and suicide and
the person also shows the changes in their own behaviour. For example, during the death of
Robin Williams, his family members are also suffer from this type of grief, because this is
sudden loss of suicide and this also leads to cause many sudden changes in their life.
Section 3
Analysis and evaluation of role of helper related to identify issue
Helpers are those person who assist an individual to overcome their specific problem.
They played specific role in order to minimize the grief from which the bereaved are suffer.
Though grief is a normal response to losing someone who is important but when someone dies
by suicide, the bereaved experience a very complicated form of grief which is the combination of
sudden shock. At that time, the helper support them and try to overcome from their grief by
provide counselling (Pybis and et.al., 2016). The pain of suicide cannot be eased quickly but at
that time, bereaved needs some people who can take care of themselves and realized them that
what has happened, deal with the grief and learn how to live with the loss. Therefore, there are
some people, group or organization who also help bereaved so that they will overcome by the
loss and in UK, there are many groups, organization who support this work such as:
Government: In UK, government made national strategy which support people after a
suicide and also improve the mental well-being of people who have been bereaved by the loss.
Moreover, It has been analysed that the people who have been bereaved by suicide are more
likely to describe in the poor social functioning and the government also establish different
organization where the person can easily go to the close bereaved member and provides support
as well. Beside this, it has been analysed that the work of the National Suicide Prevention
Alliance and Support after the Suicide Partnership which accelerated the collective
understanding of the role of posttension in supporting the individual as well as communities.
Therefore, the national suicide prevention strategy also provide effective and timely emotional
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and practical support to the close family bereaved to assist in grieving process (Ho and et.al.,
2018).
Specialist: Specialist are those person who are special in their field such that therapist
the support is needed for the children who are the bereaved by the suicide. In the case of Robin
Williams, his children are also affected with the same and at that time specialist help or support
them to overcome from this complicated grief. In the same way, Winston Wish is a therapist who
also provides the postvention support to the children and some young people, and they try to
divert the mind of the children so that they did not remember the loss from which they are
currently suffers. Apart from this, therapist also provide counselling session because it has been
analysed that children's stress level are at highest before their family members dies and it is quite
necessary to support during this time (Peters and et.al., 2016). For example, in UK, Child
Bereavement Network also provides best services to the young people and children through their
high network so that they can easily cover from this loss by suicide.
Local services: In UK, there are different local services who help the family members
such as People Experiencing Trauma and Loss which is the Scottish charity who support families
and friends of murder and suicide victims as well. The counsellor in this organization provides
counselling and support to people who have been affected by the loss of the family members due
to loss by suicide. Thus, loss by suicide is the worst shock any family member can experience in
their life and during this time the adult may feel anxiety and show the symptoms of stress as well
and this may also lead to mental health issue (Lagerros and et.al., 2017). Therefore, at that time
counsellor who work under PETAL will support the wife and husband by providing a range of
counselling and therapy session in order to treat the client individual problem and provide
pathway for treatment using some psychotherapeutic interventions.
Apart from this, local services also includes WAY Widowed and Young which is a self
help social and support network for the men as well as women who are under the age of 50 and
also affected by the death of a spouse and the partner. It is also realized that it is the only national
charity in UK for the men and women who provide support so that they will come with the issue
of their spouse's death (Pitman, 2018). In the same way, during the death of husband this local
charity offered a lifeline and counselling session so that they will fight with the situation in better
way and even, in the case of Robin William's suicide, his wife is also suffered from long
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complicated grief therefore, this local services provides way and direction to live again and re-
enter in reality.
Section 4
CONCLUSION
By summing up above report it has been concluded that loss of suicide is the biggest
problem in the world and in UK, its ratio is decline as compared to some last years. As the report
concluded the people normally in this stage are faces mentally disorder issue and some cause
depression. The report also concluded that when the people loss some member from their family
they feel complicated grief and at that time Health practitioner must provide counselling session
to them in order to overcome from the grief. Further, report also conclude normal grief and
complicated grief are two different things and by using the model of five stage of grief, it
describe different stages and further concluded some different types of complicated grief as well.
It is to be recommended to Health care that by providing effective counselling, people
can overcome from the loss by suicide and they can live better in rest of their life. Lastly, report
also concluded that government, local services and specialist are the helpers who provides
support to different family members in different ways. Further, report also concluded some ways
that must be use by Healthcare practitioner such that monitor proper medication use an mental
health of the person. Further, through this, I realized that there are different ways that can help
me to overcome any lose face in my future and the assessment also provide ways that help me to
support the people facing loss by suicide in their future as well.
Recommendation for the practice
Healthcare should use some specific ways in order to prevent the people from
complicated grief such that healthcare practitioner should monitor medication use and mental
health. Further, as a practitioner, I have to pay close attention to risk patients and especially to
those show are regularly taking mental health prescriptions. And at that time, if as a practitioner,
I observe any change in their behaviour then they should find out the reason of sudden changes
(Neimeyer, Cerel and Maple, 2017). Apart from this, there should be weekly counselling held so
that one-to-one communication should be done, so that I may realize or understand the reason of
any changes. On the other side, if the person may feel any hopelessness or makes any other
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worrisome comments then the practitioner should also ask if the patients have cause nay self-
harm.
At that time, as a practitioner, I must have to develop the trust and better relationship with
the bereaved people so that I will easily understand the ways and overcome form the complicated
grief, and they are also free to share their mood and openly discuss the mood or issue which they
are experienced. In this way, I can support the people and minimize their problem as well.
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References
Books and Journals
Arizmendi, B. J. and O’Connor, M. F., 2015. What is “normal” in grief?. Australian Critical
Care.28(2). pp.58-62.
Cho, J. and et.al., 2015. Suicide loss, changes in medical care utilization, and hospitalization for
cardiovascular disease and diabetes mellitus. European heart journal.37(9). pp.764-770.
Cosh, S. and et.al., 2019. Sensory loss and suicide ideation in older adults: findings from the
Three-City cohort study. International psychogeriatrics.31(1). pp.139-145.
Feigelman, W. and et.al., 2019. Identifying the social demographic correlates of suicide
bereavement. Archives of suicide research.23(2). pp.273-288.
Ho, T. E. and et.al., 2018. Postvention in the US Military: Survey of Survivors of Suicide Loss
from 2010-2014 (No. PERSEREC-TR-18-04). Defense Personnel and Security Research
Center Seaside United States.
Lagerros, Y. T. and et.al., 2017. Suicide, Self-harm, and depression after gastric bypass
surgery. Annals of surgery.265(2). pp.235-243.
Maccallum, F. and Bonanno, G. A., 2016. The economics of losing a loved one: Delayed reward
discounting in prolonged grief. Clinical Psychological Science. 4(4). pp.683-690.
Mayton, H. N. and Wester, K., 2019. Understanding the Experiences of Survivors of a Loss by
Suicide: A Photovoice Study. Journal of Creativity in Mental Health.14(1). pp.10-22.
Neimeyer, R. A., Cerel, J. and Maple, M., 2017. Recommendations for research on suicide loss:
A commentary. Death studies.41(10). pp.673-679.
Peters, K. and et.al., 2016. Helpful and unhelpful responses after suicide: Experiences of
bereaved family members. International journal of mental health nursing. 25(5). pp.418-
425.
Pitman, A., 2018. Addressing suicide risk in partners and relatives bereaved by suicide. The
British Journal of Psychiatry.212(4). pp.197-198.
Pybis, J. and et.al., 2016. The nature of emotional support and counselling provision for people
with sight loss in the United Kingdom. British Journal of Visual Impairment.34(2).
pp.167-176.
Stewart, J. G. and et.al., 2019. Life stress and suicide in adolescents. Journal of abnormal child
psychology, pp.1-16.
Online
Suicide Statistics and trends for UK and Republic of Ireland. 2017. [Online]. Available through:
<https://www.samaritans.org/about-samaritans/research-policy/suicide-facts-and-
figures/>.
Five stage model of normal grief. 2018. [Online]. Avaialble through:
<https://www.goodtherapy.org/famous-psychologists/elisabeth-kubler-ross.html>.
Robin William's suicide. 2018. [Online]. Avaialble
through:<http://www.scielo.br/pdf/trends/v38n3/2237-6089-trends-38-03-00178.pdf>.
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